Joint Protocol between Disabilities Teams and Children and Families Teams

This protocol applies whenever there are concerns about the welfare of children whose parents have assessed mental health difficulties, learning or physical disabilities, and there is concern that these difficulties are impacting on the parents ability to meet the needs of their children.

A major theme emerging from the child protection studies Messages From Research was the high levels of parental mental illness and or learning disability in parents of children who became involved in the child protection system.

The priority for adult services is to know which of their service users have children. For staff in Children's Services finding out about the mental and physical health of the parents of referred children is a priority. A broader approach to assessment means that the presence and needs of all family members can be considered.

This protocol will apply whenever there are concerns about a child's welfare that do not require immediate steps on behalf of the Social Services Department to protect them from significant harm.

Where it is believed that a child is suffering or likely to suffer from significant harm the ACPC Procedures for Dealing with Child Abuse must be followed and immediate referral to Children and Families Services made.

The purpose of this protocol is to improve the identification of children in need and provision of services to children and families who have assessed mental health, physical, sensory or learning disabilities.

For all referrals accepted by the Disabilities Teams (Physical and Sensory Disabilities Team and Community Team for People with Learning Difficulties) including OT.s, a check should be made whether the person has parenting responsibilities for a child under 18. If so, and where the indicators listed below point to the need for further assessment, staff should explore any parenting and child related issues in accordance with the Framework for the Assessment of Children in Need and their Families. Indicators for undertaking an Initial Screening Assessment in relation to parenting and child related issues, and completing an Inter-agency Referral Form, will include:

• Chronic and enduring mental illness in a parent, which is likely to impact on the capacity to care for a child;
• Physical or Learning disabilities in the parent that are likely to impact on their capacity to care for the child;
• Circumstances where a parent has a mental illness, physical or learning disability and there is no other adult within the household or extended family or social network whose involvement can compensate or ameliorate the impact of the parents difficulties and there is likely to be impairment to the child's health or development;
• Where it is apparent that a young person has taken on a caring role for the adult, which has a serious impact on their health or development.

Where it is identified at the referral stage that the adult has needs that require assessment under the Community Care Act and the child has needs that require assessment under the Children Act 1989, the first Team to receive such a referral must act as the Nominated Co-ordinator until the assessments are completed and a decision made about service provision. This should enable service users to have a single point of contact and prevent them having to approach several different teams.

The function of the Nominated Co-ordinator is to ensure that referrals are made to relevant teams for assessment and that arrangements are made for multiple assessments within the same family to be considered at the same time so that the impact of one upon another is recognized and taken into account in any service provision.

Where there is professional disagreement about the relevant Nominated Co-ordinator this should be resolved between relevant managers.

Whenever the disabilities team worker identifies that a Service User has parenting responsibilities, and the care of a child or young person under the age of 18 years, and indicators for an initial screening assessment of the parenting and child related issues apply (see Section 2, Referrals Received by Disabilities Teams,), they will complete the Inter-agency Referral Form. Where it is felt that the indicators do not apply, the worker will discuss this with their supervisor/manager, within the supervisory process.

The worker for the Adult will complete the Inter-agency Referral Form in partnership with the parent using the Framework for Assessing Children in Need and their families. The form will be completed within 7 days from its commencement. On completion of the assessment the worker for the Adult will pass the completed form to their manager.

The Inter-agency Referral Form will be completed by the disabilities Team worker in accordance with their own professional role and perspective. It may not be possible for the worker to complete all sections of the form in detail, for example the section dealing with Children's developmental needs may need a more focused assessment by the Children and Families Team where appropriate. Disabilities Team staff should focus on identifying concerns known to them, and filling in what they can of the form.

Where the assessment indicates that the parental difficulties are impacting on the parents capacity to care for the child and the child is a child in need whose health or development is being impaired, and the adult service user is agreeable, the disabilities worker will make a referral to the Children and Families Services.

On completion of an inter agency referral form, where it is judged that the child is a child in need and the parent is agreeable to the referral being made, the Disabilities Manager will forward a copy of the completed Inter-agency Referral Form to the Children and Families Services.

Children and Families Services will provide consultation via the Referral and Assessment Team to Disabilities Team staff as appropriate, for example about the appropriateness of referrals or eligibility for service.

Immediate referral will be made to the Children and Families Services whenever it is assessed that a child is suffering or likely to suffer significant harm. (ACPC Procedures for Dealing with Child Abuse).

On receipt of a completed Inter-agency Referral Form from, the manager of the appropriate Children and Families team will give consideration whether the eligibility criteria is met for services to be provided, an assessment undertaken, child protection enquiries commenced or no further action is required.

Consideration will always be given to the impact of the adults. mental health, physical or learning disabilities on their capacity to care for the child and of the associated level of impairment of the child's health and development. Consideration will always be given to the provision of family support services to support the adult in meeting the identified needs of the child.

Children and Families Manager's will ensure that Disability Managers are informed within 24 hours of receipt of the completed Inter-agency Referral Form, in writing about the decisions made by Children and Families Services regarding future involvement with the family.

In all cases where an Assessment is undertaken consideration will be given to the impact of the parents/carers mental health, learning or physical disabilities on their capacity to care for a child.

Where an adult appears to have community care needs the children and families Team will seek consent of the adult to refer to the Disabilities Team for assessment, unless the adult is vulnerable and in need of protection where a referral may be made without consent.

In all cases where it is identified that a parent may have physical, sensory, mental health or learning disabilities, that seriously impact on the adult's capacity to meet the needs of their child, children's services will undertake an Assessment in line with Working Together to Safeguard Children. Where it is assessed that the adult may also have community care needs a referral will be made by the children and families team to the Disabilities Team and a copy of the Assessment Form provided with the parent's consent.

In exceptional cases where a vulnerable parent is experiencing abuse or exploitation an immediate referral will be made to the Disabilities Team with the adult's knowledge if consent is not achievable.

Disabilities Teams will provide consultation to children's services undertaking assessments as appropriate.

On receipt of the Assessment and referral by Children's Services the Disabilities Team Manager will arrange for a further Needs Led Assessment to be carried out.

On completion of the Needs Led Assessment, the Disabilities Team will consider whether the eligibility criteria is met for the provision of services, and develop a care plan as appropriate.

Personal information about Children and Families held by professionals and agencies is subject to a legal duty of confidence and should not normally be disclosed without the consent of the subject. Unless it is assessed that the child is suffering or likely to suffer from significant harm the consent of a person with parental responsibility should normally be obtained before making a referral to the Children and Families Services. Where the person with parental responsibility is judged by Disabilities Worker to be unable to make a decision in the best interest of their child information may be shared with the Children and Families Services without their consent if it is judged that good outcomes for the child would not otherwise be achieved.

Following a referral working together should not be seen as requiring an automatic joint visit by representatives of both services. Opportunities should be created for consultation, advice, and clarification by both services. However, where both adults and children are initially assessed as having significant needs joint or co-working may be required between Children's and Disability Team staff to ensure that the needs of the family are met. This may happen at the Assessment, the Care Planning stage, or first or subsequent reviews.

In some cases it may be appropriate for one team to provide a service and receive consultation from the other.

In all cases the decisions made about joint co-working should be clearly recorded on the Care Plan on the respective case files and explained to the Service User.

Statutory requirements for Care Planning for both children and adults must be observed and within this process the child's needs must be the paramount consideration if there is a conflict between the needs of the adult and the needs of the child.

Agreement about the respective professional roles must be negotiated, explained to the Service User and recorded on the care plan and file.

Where it is necessary to convene adult or child focused meetings consideration should be given to inviting the relevant Disabilities Team Worker from the other service to attend to ensure that Care Plans devised are compatible.

Where there is no statutory requirement to convene meetings it may be appropriate to jointly convene a planning meeting for the dual aims of Care Planning to meet the needs of children and their parents. The chairing of these meetings will need to be negotiated and the aims clarified.

Where services are to be purchased it may be appropriate to jointly commission in which case the budget holders within each service must agree the apportionment of costs on a case by case basis in line with eligibility criteria.

The appropriate financial procedures for each service must be followed.